Advances in the diagnosis and treatment of Sjögren disease.

PURPOSE OF REVIEW: Sjögren disease (SjD) constitutes a diagnostic and therapeutic challenge due to its clinical heterogeneity and complex pathophysiology. This review synthesizes recent advances in diagnostics, disease stratification, and targeted therapies, highlighting their potential to optimize patient care.

RECENT FINDINGS: Emerging diagnostic approaches include advanced salivary, lacrimal, and serum biomarkers, refinements of established diagnostic tools, role of specific autoantibodies, and AI-assisted histopathology, improving early detection and risk stratification, particularly for lymphoma-prone phenotypes. Novel immunological insights have enabled phenotype-based classification, guiding the development of targeted therapies against B-cell pathways, cytokines, and co-stimulatory molecules with several agents (e.g., belimumab, ianalumab, telitacicept) showing promise in reducing disease activity scores.

SUMMARY: Recent advances provide a framework for precision medicine in SjD, integrating molecular and imaging biomarkers into patient selection and treatment monitoring. Clinically, this could enable earlier diagnosis, individualized risk assessment, and tailored therapy. Research priorities now include validating diagnostic innovations in diverse populations, elucidating phenotype-specific mechanisms, and conducting adequately powered, biomarker-driven trials to optimize therapeutic efficacy.